Rumination disorder, or rumination syndrome, is an eating disorder. It causes the repeated and unintentional regurgitation of food, usually during or just after eating. Experts still have much to learn about this condition.
People with this disorder may also experience other symptoms, such as nausea, bloating, and dizziness. Although there is no known way to prevent the disorder, behavioral therapies can help treat it.
This article looks at the causes, symptoms, diagnosis, and treatment of rumination disorder.
Rumination disorder is a
The regurgitation appears effortless, meaning that it is automatic and difficult to control. People with rumination disorder may re-swallow, re-chew, or spit out the regurgitated food.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Rumination disorder is different than other eating disorders that involve regurgitating food. People with anorexia nervosa or bulimia nervosa may regurgitate food as a way to control their weight, but it will typically be deliberate rather than unintentional.
Many people with rumination disorder have neither anorexia nervosa nor bulimia nervosa. However, some people with these eating disorders may go on to develop rumination disorder.
Doctors may sometimes mistake rumination disorder for gastroesophageal reflux disease (GERD). GERD is a chronic digestive disorder that involves persistent acid reflux.
Common symptoms of GERD include:
- swallowing difficulties
- painful swallowing
- pain in the upper abdomen
A wide range of health conditions can cause GERD, which is not an eating or feeding disorder. GERD does not cause the regurgitation of undigested food.
The main symptom of rumination disorder is the frequent and effortless regurgitation of food, which usually happens 15–30 minutes after eating. People may also experience:
- a feeling of pressure or the need to belch beforehand
- difficulty sleeping
In some cases, regurgitation may cause further symptoms, including:
- dental damage
- weight loss
Children and adolescents may experience:
- abdominal pain
Researchers do not know the exact causes of rumination disorder. In children, possible causes include:
- severe stress
- a previous eating disorder, such as bulimia nervosa
- lack of environmental stimulation
The authors of a
- a medical procedure
- a respiratory infection
- psychological stress
- eating disorder history
Researchers still need further evidence to confirm these connections and determine exactly what causes rumination disorder.
Rumination disorder can sometimes resolve by itself, especially in young children. However, many people with this condition do require treatment.
Diaphragmatic breathing involves learning to engage the stomach, abdominal muscles, and diaphragm when breathing. People with rumination disorder often find that this technique can improve their symptoms.
Doctors may recommend other treatment options alongside breathing techniques. These may include:
- general relaxation
- distractions, such as chewing gum
- aversion training
- cognitive behavioral therapy
If these treatments do not work, doctors may recommend medication. The drug baclofen may help improve symptoms, but the Food and Drug Administration (FDA) has not yet approved it for this use.
According to the International Foundation for Gastrointestinal Disorders, researchers used to think that rumination disorder was more common in infants and people with developmental conditions. However, they now recognize that the disorder can affect people of any sex, age, and cognitive ability.
In children and adolescents with no developmental conditions, rumination disorder may be more common in females than males.
According to the DSM-5, doctors should only diagnose rumination disorder when the following
- a person experiences repeated regurgitation of food for at least 1 month
- the regurgitation is not due to a gastrointestinal condition or another eating disorder
- the person does not retch after regurgitation
The National Institutes of Health (NIH) also list the following criteria for diagnosis:
- standard treatment for GERD does not improve symptoms
- regurgitation happens shortly after eating and not during sleep
- the symptoms first began more than 6 months ago and have occurred for a total of 3 months or more since then
As researchers do not know the exact cause of rumination disorder, there is currently no known way of preventing it.
Rumination disorder may cause complications, such as:
- weight loss
- dental damage
- electrolyte imbalances
Rumination disorder does not usually cause any physical harm to the body, and breathing techniques and behavioral therapy are often effective in treating symptoms of the disorder.
As a result, the outlook for people with this disorder is usually very good. However, people with other associated physical or psychological conditions may require additional treatment.
Anyone who experiences symptoms of rumination disorder should speak with a healthcare professional, who will be able to rule out any other conditions and suggest a treatment plan.
While waiting for their appointment, a person can track their symptoms in detail, noting the timings of regurgitations after eating. This information can help the healthcare professional distinguish rumination disorder from other conditions, such as GERD.
Rumination disorder is a rare eating disorder that causes people to regurgitate undigested food during or shortly after eating. The regurgitation is unintentional, but breathing techniques and behavioral therapy can help a person manage it.
Although much remains unknown about rumination disorder, further research should help the medical community better identify and treat this condition.